Shanti Homes 1

Type of visit: Required - 1 Year

Licensing Program Analysts (LPA) B. Miranda & A. Porter conducted an unannounced visit today for the facility’s annual inspection. LPAs introduced themselves and was allowed entrance into the facility. LPA met with Administrator Sandeep Dhand. Facility is licensed for 6 residents and has a current census of 5. There is 1 resident on hospice and 0 with a health care. Water temperature was checked in the kitchen which read at 109 degrees Fahrenheit and the common bathroom which read at 103.6 degrees Fahrenheit. Fire Extinguisher was serviced May 29, 2026 and is within the safety regulation period. Smoke and carbon monoxide detectors were tested and in working order. Sandeep Dhand Administrator's Certification expires September 25, 2027. Staff files were reviewed, there is no verification of the completed required hours for medication training, staff only have 2 hours of medication training. S1's file was not complete and is currently not associated to the facility. Resident files were reviewed, R1 & R5 do not have current physician reports. Facility provided a log for disaster drills that are conducted quarterly. First aid kit on site. Toxins and cleaning supplies are locked and inaccessible inside the house. LPA observed an unlocked shed with cans of paint and insect spray. There is a locked storage for medications. LPA observed knives and scissors in unlocked kitchen drawer. LPAs observed the following items to be unsanitary or in good repair: Pest debris in dishwasher Pantry door unkept/unsanitary Kitchen floor to be unkept/unsanitary Broken shower door handle with a sharp edge in common bathroom R2’s room had urine odor LPAs observed the following deficiencies: Food times in fridge and pantry not properly labeled or dated Oxygen training verification not provided, current hospice care plan not provided R2 PRN medication was not given or documented properly LPAs observed R2's medication being stored in additional container and not in original container Administrator/House manager is not at the facility during normal business hours to operate facility efficiently Facility does not have “No smoking, oxygen in use" signs R3 has multiple extension cords plugged into each other Stove knobs to be on the stove throughout the inspection and hygiene products accessible throughout the facility R4 is not on hospice and does not have an order for full bed rail No written notice to the Fire Dept regarding R3’s oxygen LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms, bathrooms, medication storage, kitchen, garage, and outdoor area. Bedrooms were clean, properly furnished, with adequate lighting. Facility has perishable and non-perishable food items. Deficiencies observed were cited during today's inspection per California Code of Regulations, Title 22. LPA is requesting the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing by June 10, 2026. TSP was offered, Administrator denied at this time. Exit interview conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Sandeep Dhand.the state’s words, verbatim · CDSS document, Jun 3, 2026

Type of visit: Prelicensing

On 5/23/25 Licensing Program Analyst (LPA) M. Garza arrived for an announced pre-licensing inspection visit. LPA was met by Licensee, Sandeep Dhand. LPA introduced self, reason for visit and was permitted entry into the facility. Facility is in the process of pre-licensing. Currently 4 residents are residing in the facility and receiving care. 2 dementia residents, 1 hospice and 1 home health services being provided to residents currently. LPA completed a health and safety check on residents in care. Residents observed in common area watching television and in rooms. Tour of facility inside and out. All required postings are posted. Common areas observed with adequately furnishings and lighting. LPA observed an extra supply of linens and personal hygiene/grooming products. Kitchen observed with dishes, plates and utensils. Cleaning supplies/chemicals observed in a locked storage shed. Medications observed in a kitchen closet locked and inaccessible to residents in care. Fire extinguishers present and last serviced on 1/21/25. Fire alarm and carbon monoxide detectors are present and operational. Outside of the facility exits open free of obstruction. Facility has a functioning phone. Phone number is: (661) 829-5036. First aid kits observed with required items. Component III conducted during this pre-licensing visit. At this time the facility is ready to be licensed. LPA will notify CAB. A copy of this report was provided.the state’s words, verbatim · CDSS document, May 23, 2025

Type of visit: Prelicensing

On 5/5/2025 Licensing Program Analyst (LPA) M. Garza arrived for a pre-licensing visit. LPA met with Licensee/Administrator, Sandeep Dhand, explained reason for visit and was permitted entry into the facility. During tour of the facility, LPA observed the facility was not ready for pre-licensing. LPA discussed corrections that would be needed, pre-licensing care tool, resident files and emergency disaster plan with Licensee. Pre-Licensing was rescheduled for Monday, May 12, 2025 @1pm. No deficiencies cited during todays visit. Exit interview completed with Licensee. A copy of this report provided.the state’s words, verbatim · CDSS document, May 5, 2025

Type of visit: Office

COMP II by CAB successfully completed Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 5 Method: Telephone call with CAB COMP II Participants: Sandeep Dhand, Administrator/Owner; Shannon Betker, analyst. Applicant/administrator participated in COMP II at CAB via telephone call with analyst at CAB. Identification of the applicant and administrator was verified by confirming driver’s license number. During COMP II, applicant and administrator confirmed the understanding of Title 22. Component II was successfully completed. Applicant and administrator were advised to email/fax signed LIC 809 with copy of photo ID to CAB. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-licensing readinessthe state’s words, verbatim · CDSS document, Apr 15, 2025